ABC | Volume 112, Nº5, May 2019

Original Article Andrade et al Stent versus CABG: a meta-analysis Arq Bras Cardiol. 2019; 112(5):511-523 Figure 2 – STENT versus CABG: One-year mortality (top) and late mortality (bottom). The size of each box is proportional to the number of patients of the trial. The bars represent 95% confidence interval. The diamond represents the syntheses of results. DES: trials of the drug-eluting stent era; BMS: trials of the bare-metal stent trials era; CABG: coronary artery bypass grafting;ARTS:Arterial Revascularization Therapies Study;AWESOME:Angina with extremely severe outcomes; ERACI II:Argentine randomized study: coronary angioplasty with stenting versus coronary bypass surgery in patients with multi-vessel disease; MASS II: Medicine, Angioplasty, or Surgery Study; SOS: Stent or Surgery trial; BEST: Bypass Surgery and Everolimus-Eluting Stent Implantation in the Treatment of Patients with Multi-vessel Coronary Artery; Boldriot, trial of Boldriot et al: J Am Coll Cardiol. 2011; 57: 538-545. CARDia: Coronary artery revascularization in diabetic; LE MANS: Left main coronary artery stenting; EXCEL: Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization; FREEDOM: Future Revascularization Evaluation in Patients with Diabetes Mellitus; NOBLE: Nordic-Baltic-British Left Main Revascularization Study; PRECOMBAT: Premier of Randomized Comparison of Bypass Surgery versus Angioplasty Using Sirolimus-Eluting Stent in Patients with Left Main Coronary Artery Disease; SYNTAX: Synergy between PCI with Taxus and Cardiac Surgery; Va-Cards: Coronary Artery Revascularization in Diabetes in VA Hospitals. –0.2 –0.1 0.1 0.2 0 –0.2 –0.1 0.1 0.2 0 Favours stent Favours CABG Favours stent Favours CABG 1750 15 2 5 8 38 30 4 17 8 30 5 8 38 32 1 9 6 39 8 143 145 198 220 17 17 8 4 75 29 600 222 225 205 498 13 7 8 12 55 1765 29.7% –0.01 [–0.02, 0.00] –0.00 [–0.02, 0.02] –0.07 [–0.12, –0.01] –0.04 [–0.09, –0.00] –0.00 [–0.04, 0.04] –0.03 [–0.08, 0.02] –0.00 [–0.03, 0.03] 0.00 [–0.02, 0.02] 0.00 [–0.01, 0.02] –0.06 [–0.14, 0.02] –0.01 [–0.03, 0.00] –0.01 [–0.03, 0.02] 0.01 [–0.01, 0.03] 0.03 [–0.04, 0.10] –0.00 [–0.03, 0.03] 0.01 [–0.02, 0.04] 0.01 [–0.05, 0.07] 0.02 [–0.00, 0.04] –0.09 [–0.26, 0.08] 0.01 [–0.02, 0.03] –0.02 [–0.07, 0.02] 0.03 [–0.00, 0.06] 0.03 [0.00, 0.06] –0.03 [–0.10, 0.05] –0.04 [–0.10, 0.01] –0.01 [–0.10, 0.07] 0.04 [0.01, 0.08] 0.02 [0.00, 0.03] 4191 4135 70.3% –0.00 [–0.01, 0.01] 5941 5903 100.0% –0.00 [–0.01, 0.00] 1727 1744 29.1% –0.00 [–0.02, 0.02] 4292 4175 70.9% –0.02 [–0.00, 0.03] 6019 5919 100.0% –0.01 [–0.00, 0.02] 605 232 225 203 250 10.2% 3.8% 3.8% 3.4% 8.4% 100 101 1.7% 4.2% 16.0% 16.1% 0.9% 10.0% 5.1% 14.7% 1.7% 246 948 953 52 592 300 849 97 254 948 953 52 592 300 891 101 44 41 16 48 53 202 590 222 222 205 488 46 49 26 50 34 205 584 232 225 203 500 9.8% 3.8% 3.7% 3.4% 8.3% 28 35 71 114 11 36 17 123 435 437 254 913 894 52 592 279 871 22 440 248 903 859 53 592 275 805 31 33 83 16 33 23 92 353 637 558 7.3% 4.2% 15.2% 14.7% 0.9% 9.9% 4.6% 14.0% 1.3.1 BMS Subtotal (95% Cl) 1.3.2 DES 1.4.1 BMS 1.4.2 DES Subtotal (95% Cl) Subtotal (95% Cl) Subtotal (95% Cl) Total (95% Cl) Total (95% Cl) One year mortality ARTS 2001 AWESOME 2001 MASS II 2004 ERACI II 2001 SOS 2004 SYNTAX 2009 VA-CARDIS 2013 Boudriot et al 2011 EXCEL 2010 CARDIA 2010 FREEDOM 2012 LE MANS 2008 NOBLE 2016 PRECOMBAT 2011 CARDIA 2010 SYNTAX 2009 BEST 2015 EXCEL 2016 FREEDOM 2012 LE MANS 2008 NOBLE 2016 PRECOMBAT 2011 ARTS 2001 Late mortality AWESOME 2001 ERACI II 2001 MASS II 2004 SOS 2002 Total events Test for overall effect: Z = 1.72 (p = 0.09) Heterogeneity: Chi 2 = 19.30, df = 4 (p = 0.0007); I 2 = 79% Total events Test for overall effect: Z = 0.25 (p = 0.80) Heterogeneity: Chi 2 = 7.31, df = 8 (p = 0.50); I 2 = 0% Total events Test for overall effect: Z = 1.16 (p = 0.25) Test for subgroup differences: Chi 2 = 1.74, df = 1 (p = 0.19); I 2 = 42.4% Heterogeneity: Chi 2 = 22.83, df = 13 (p = 0.04); I 2 = 43% Total events Test for overall effect: Z = 2.09 (p = 0.04) Test for subgroup differences: Chi 2 = 1.76, df = 1 (p = 0.18); I 2 = 43.3% Heterogeneity: Chi 2 = 16.06, df = 12 (p = 0.19); I 2 = 25% Total events Test for overall effect: Z = 0.03 (p = 0.97) Heterogeneity: Chi 2 = 8.25, df = 4 (p = 0.08); I 2 = 52% Total events Test for overall effect: Z = 2.58 (p = 0.010) Heterogeneity: Chi 2 = 6.85, df = 7 (p = 0.44); I 2 = 0% Study or Subgroup Stent CABG Risk Difference Risk Difference Events Total Events Total Weight M-H, Fixed, 95% Cl M-H, Fixed, 95% Cl 516